First Things First (assess & treat for the following)

• Notification Procedures in the Event of a Bioterrorist Incident
  • First call the Public Health Officer at your local health department; after hours contact local Health Director via 911.
  • If no answer at local health department, call the State Communicable Diseases Branch or CDC.
    • CDC emergency assistance number 770-488-7100
    • California Department of Health Services for information, botulism immune globulin (24-h telephone: 510-540-2646)
  • If criminal activity is suspected, call your local law enforcement and the FBI.
• Botulinum toxin as a bioterrorism agent: CDC Category A agent -- easily disseminated, high mortality, public panic, special measures
• Botulinum toxin poses a major bioweapon threat because of its extreme potency and lethality; its ease of production, transport, and misuse; and the need for prolonged intensive care among affected persons (JAMA 2001;285:1059-1070)
• Aerosols were dispersed at multiple sites in downtown Tokyo, Japan, and at U.S. military installations in Japan on at least 3 occasions between 1990 and 1995 by the Japanese cult Aum Shinrikyo.